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How is it performed? of Cataract surgery
You may have a cataract in one or both eyes. If you have cataracts in both eyes and they both need removing, this is carried out as two separate operations a few months apart. This is to allow the first eye to recover and vision to return.
A cataract is normally removed using a procedure called ‘phacoemulsification’. Using a microscope with a light on the end, the surgeon makes a tiny cut (incision) of about 3mm in the surface (cornea) of the eye. This is usually just under the upper eyelid at the edge of the iris (the coloured part of the eye).
The cataract is then dissolved painlessly using a special instrument called a phacoemulsification needle. This gives off high-energy ultrasound waves, which break down the cataract into small soft pieces so they can be sucked out through the centre of the needle. A new plastic (artificial) lens called an intraocular lens (IOL) is folded in half, squeezed through the cut that has been made and unfolded inside the eye. The incision seals up itself and doesn’t need stitches.
Phacoemulsification is usually carried out under local anaesthetic, which means you stay awake during the procedure but you won’t feel any pain. A nurse will make sure you are comfortable and reassure you if you are nervous. If you want to, you can have a sedative before the operation to help you feel relaxed and sleepy. A local anaesthetic is normally used for cataract surgery because it has fewer risks than general anaesthetic, and you will also recover more quickly after the operation.
Before the operation, eye drops are given to open up (dilate) the pupil. You won’t be able to see out of the eye while it is being treated, although you’ll be able to see some light. The operation is performed in an operating theatre while you are lying down on your back. Lightweight drapes (special sheets) will be placed over your face to keep germs out of your eye but there will be a space for you to breathe through. Your eyelids will be opened up using a small instrument called a speculum. The operation usually takes between 15 and 20 minutes and you will normally be able to go home the same day.
Less commonly, an operation called manual extracapsular extraction may be carried out. This makes a larger incision into the eye and removes the lens in one piece. An artificial lens is put in and the cut on the eyeball is closed with dissolvable stitches. You may need to stay in hospital a little longer if you have this procedure.
After surgery, a pad or clear piece of surgical tape may be put across your eye to protect it. You can take this off after a few hours.
